Individual
MR. BRADLEY ALLEN BADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
290 RAILROAD ST, TAMMS, IL 62988-5038
(618) 253-8450
Mailing address
290 RAILROAD ST, TAMMS, IL 62988-5038
(618) 747-2391
(618) 747-2371
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14176
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402035307
—
MO
Enumeration date
03/29/2007
Last updated
06/17/2020
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